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29 MARCH 2019 VOLUME 20 ISSUE 12

Media Coverage

Although some women and girls may have acknowledged or celebrated National Women and Girls HIV/AIDS Awareness Day on March 10, all women should continue their awareness throughout the year, Janette Wheat, Ph.D, said.

Construction has started on a multimillion dollar AIDS drug factory that will become the largest in Africa when it opens later this year. The $100m (£75m) facility will bring 1,000 jobs to Kenya and reduce the reliance of almost half of the continent’s countries on European imports.

“Every time you have sex without a condom, you are asking to die.” The man appeared to be in his 50s. He was angry, raising his voice as he chastised the panelists, men in their 20s who admitted they preferred to have sex without condoms.

How do we eradicate HIV/AIDS? One route is a vaccine, but so far that has proved a very difficult research problem. There is an ongoing clinical trial of one promising treatment in South Africa, but unlike the smallpox or polio vaccines, it appears to provide only moderate protection. Another is "pre-exposure prophylaxis," or PrEP — drugs which prevent HIV infection if taken every day. One such treatment called emtricitabine/tenofovir (better known by its brand name Truvada) works very well for this, cutting the risk of infection by up to 93 percent.

Most modern epidemics end with a vaccine or a cure. HIV has neither. We are betting on a biomedical solution that has a huge behavioral mountain to scale. Unlike vaccines or a cure that required a limited number of visits to your doctor, our biomedical solution asks people living with HIV to stay in healthcare and adherent to their meds for the rest of their lives and for people on PrEP to stay in healthcare and adherent to their meds for as long as they are sexually active.

On Monday, Nina Martinez, a 36-year-old public health expert, became the first living person with HIV in the United States to donate a healthy kidney to another person with HIV. The transplant, according to surgeons who performed the surgeries, was a success.

The other day, my patient, who I’ll call Sam, came in for a routine sexually transmitted infection (STI) screening for two reasons. First, he said that he just started a new relationship with someone he met on a dating app and wanted to make sure he was in the clear. He didn’t have any symptoms that day. Second, he read somewhere that STIs are on the rise and he was concerned.

In a different city, in a different decade, the news would have changed David’s life forever. Instead the graduate student, who dreams of someday acting and teaching, told himself one thing as he waited for test results in the San Francisco General Hospital emergency room: “If it comes back and it’s positive, just do what you can to stay healthy.... If it comes back negative, be even more careful.”

The global AIDS response has made significant progress in reducing HIV infections and AIDS-related deaths. New HIV infections dropped by 16 percent from 1.9 million 2010 to 1.6 million in 2017. And the number of AIDS-related deaths decreased from 1.4 million to 940 000 in the same period.

The Ethiopian government on Wednesday revealed that more than 16,000 Ethiopians die due to HIV/AIDS every year. The new study, which was released by the Ethiopian Public Health Institute on Wednesday that reviewed the status of HIV/ADIS in the country, revealed that some 16,000 Ethiopians are infected by the deadly virus annually, while the virus caused in excess of 16,000 deaths every year.

The human immunodeficiency virus (HIV) is no longer a death sentence, yet a cure remains elusive. While current therapies can successfully manage active infection, the virus can survive in tissue reservoirs – including macrophage cells, which play an important role in the immune system.

Thomas Folks spent years in his U.S. Centers for Disease Control and Prevention lab developing a treatment to block deadly HIV in monkeys. Then San Francisco AIDS researcher Robert Grant, using $50 million in federal grants, proved the treatment worked in people who engaged in risky sex.

Young women aged 20-24 in Nigeria are three times more likely to be living with HIV than men of the same age. In this group, HIV prevalence was 1.3 percent compared to 0.4 percent in men according to a newly published Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS), one of the largest population-based HIV/AIDS household surveys ever conducted

President Trump’s State of the Union speech kicked off the year with some dramatic gestures toward “global leadership,” promising to put the United States at the forefront of a crusade to end the AIDS crisis worldwide. But between the lines, Trump’s global humanitarian agenda is actually undermining health care in the communities most deeply afflicted by HIV/AIDS.

Achieving an undetectable viral load is a great thing. “Undetectable” basically means the amount of HIV in your body is so low that it cannot be detected by current monitoring tests. It doesn’t mean one is cured or HIV-negative, but it does mean one can live a long and healthy life. That’s the primary benefit of an undetectable status, and it’s great news for the health and wellness of people living with HIV. But this can only be achieved through HIV treatment, and that means accessing quality health care.

Published Research

While the WHO recommends PrEP with quarterly HIV testing, our analysis identifies PrEP with semi-annual testing as the cost-effective HIV prevention strategy for Indian MSM and PWID. Since nationwide scale-up would require a substantial fiscal investment, areas of highest HIV incidence may be the appropriate initial targets for PrEP scale-up.

A proposed strategy to cure HIV uses latency-reversing agents (LRAs) to reactivate latent proviruses for purging HIV reservoirs. A variety of LRAs have been identified, but none has yet proven effective in reducing the reservoir size in vivo. Nanocarriers could address some major challenges by improving drug solubility and safety, providing sustained drug release, and simultaneously delivering multiple drugs to target tissues and cells....

The high HIV incidence in PROUD suggests that most participants appropriately judged their need for PrEP. Eligibility criteria for a PrEP programme can therefore be broad, as in the current guidelines. However, a recent history of syphilis or rectal CT/GC, or multiple ncRAI partners indicates a high imminent risk of HIV infection. MSM with any of these characteristics should be offered PrEP as a matter of urgency.

The idea of eliminating infectious diseases from society dates to the 18th century, when Edward Jenner envisioned elimination of smallpox through widespread vaccination. By 1997, the difference between control, eradication, and elimination had been defined. Of the perinatally acquired infections, only tetanus, HIV, and syphilis have been targeted for elimination.

In this manuscript, we revise relevant work concerning the selection of vaginal/rectal dosage forms and vehicle formulation development for the administration of microbicide nanosystems. We also pinpoint major gaps in the field and provide pertinent hints for future work.

Thematic analysis of men's narratives revealed three central stories about the perceived impact of PrEP: (1) PrEP has a positive impact on public health by preventing HIV transmission (endorsed more frequently by men in the older and younger cohorts); (2) PrEP has a positive effect on gay and bisexual men's sexual culture by decreasing anxiety and making sex more enjoyable (endorsed more frequently by men in the middle and younger cohorts); and (3) PrEP has a negative impact on public health and sexual culture by increasing condomless, multi-partner sex (endorsed more frequently by men in the middle and younger cohorts). Results are discussed in terms of the significance of generation cohort in meanings of sexual health and culture and implications for public health approaches to PrEP promotion among gay and bisexual men.

Overall, this mathematical modelling study argues for the experimental investigation of EFV as a cost-efficient alternative PrEP candidate based on its superior prophylactic efficacy and forgiveness to incomplete adherence and event-driven usage. However, further analysis emphasising on the safety of EFV in the context of PrEP/PEP is warranted.

Phylodynamic methods that include realistic features of HIV genetic diversification have come of age, significantly improving inference of key epidemiological parameters. This opens the door to more accurate surveillance and better-informed prevention campaigns.

March 1, 2019

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Current Opinion in HIV and AIDS

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Weekly NewsDigest

The Weekly NewsDigest is a compilation of HIV prevention research media coverage and relevant science in peer-reviewed journals; material on other reproductive health issues; and matters of policy and politics relevant to HIV prevention research, development and advocacy.

Its purpose is to raise awareness around the range of opinions and information about HIV prevention research disseminated in the press and scientific journals and provide a neutral, objective basis for decision-making and evidence-based advocacy.

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The Black lives of AVAC’s staff, partners and friends matter. The Black lives of those who live near our office in Harlem matter. The Black lives of those on the streets across the United States and around the world calling for justice and equity matter. It’s more important than ever to say these fundamental truths.

The AVAC team is united in sorrow and anger at the inequities that are being laid bare in America today. We advocate every day for an equitable HIV response, but we know that we can’t stop there. We stand with those who are calling for a more just and equitable world.

We have the benefit of history to provide a clear vision of what must happen with COVID-19. We stand on the shoulders of giants in the fight against HIV who never took “no” for an answer: advocates who demanded a vaccine because they knew their lives depended on it. At the same time, they acted as if a vaccine would never arrive, thereby accelerating the development and delivery of safe and effective treatment and prevention options.